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Combining Quantitative Susceptibility Mapping with Automatic Zero Reference (QSM0) and Myelin Water Fraction Imaging to Quantify Iron-Related Myelin Damage in Chronic Active MS Lesions.

TitleCombining Quantitative Susceptibility Mapping with Automatic Zero Reference (QSM0) and Myelin Water Fraction Imaging to Quantify Iron-Related Myelin Damage in Chronic Active MS Lesions.
Publication TypeJournal Article
Year of Publication2018
AuthorsYao Y, Nguyen TD, Pandya S, Zhang Y, S Rúa H, Kovanlikaya I, Kuceyeski A, Liu Z, Wang Y, Gauthier SA
JournalAJNR Am J Neuroradiol
Volume39
Issue2
Pagination303-310
Date Published2018 Feb
ISSN1936-959X
KeywordsAdult, Female, Humans, Image Interpretation, Computer-Assisted, Iron, Magnetic Resonance Imaging, Male, Multiple Sclerosis, Myelin Sheath, Neuroimaging, Retrospective Studies, Water, Young Adult
Abstract

BACKGROUND AND PURPOSE: A hyperintense rim on susceptibility in chronic MS lesions is consistent with iron deposition, and the purpose of this study was to quantify iron-related myelin damage within these lesions as compared with those without rim.

MATERIALS AND METHODS: Forty-six patients had 2 longitudinal quantitative susceptibility mapping with automatic zero reference scans with a mean interval of 28.9 ± 11.4 months. Myelin water fraction mapping by using fast acquisition with spiral trajectory and T2 prep was obtained at the second time point to measure myelin damage. Mixed-effects models were used to assess lesion quantitative susceptibility mapping and myelin water fraction values.

RESULTS: Quantitative susceptibility mapping scans were on average 6.8 parts per billion higher in 116 rim-positive lesions compared with 441 rim-negative lesions ( < .001). All rim-positive lesions retained a hyperintense rim over time, with increasing quantitative susceptibility mapping values of both the rim and core regions ( < .001). Quantitative susceptibility mapping scans and myelin water fraction in rim-positive lesions decreased from rim to core, which is consistent with rim iron deposition. Whole lesion myelin water fractions for rim-positive and rim-negative lesions were 0.055 ± 0.07 and 0.066 ± 0.04, respectively. In the mixed-effects model, rim-positive lesions had on average 0.01 lower myelin water fraction compared with rim-negative lesions ( < .001). The volume of the rim at the initial quantitative susceptibility mapping scan was negatively associated with follow-up myelin water fraction ( < .01).

CONCLUSIONS: Quantitative susceptibility mapping rim-positive lesions maintained a hyperintense rim, increased in susceptibility, and had more myelin damage compared with rim-negative lesions. Our results are consistent with the identification of chronic active MS lesions and may provide a target for therapeutic interventions to reduce myelin damage.

DOI10.3174/ajnr.A5482
Alternate JournalAJNR Am J Neuroradiol
PubMed ID29242359
PubMed Central IDPMC5812818
Grant ListTL1 TR000456 / TR / NCATS NIH HHS / United States
UL1 TR002384 / TR / NCATS NIH HHS / United States
R01 NS104283 / NS / NINDS NIH HHS / United States
R01 NS090464 / NS / NINDS NIH HHS / United States
UL1 TR000457 / TR / NCATS NIH HHS / United States

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